I can’t say that often enough, so I’m going to say it again: dementia rates are falling. Previous small studies have found the same trend, and a large national survey recently confirmed it. The total number of cases will rise along with the number of older people in the population, but the likelihood of any given person getting dementia has dropped—significantly. Lead author Dr. Kenneth Langa estimates the decrease at 25 to 30 percent compared with the rate in the early 1990s. And people are being diagnosed at older and older ages.

This comes as a surprise to epidemiologists along with the rest of us, especially give a surge in diabetes among older Americans, which significantly increases the risk of dementia. It’s part of a larger trend that that New York Times has dubbed a “medical mystery of the best kind”: common diseases of aging are in retreat in the United States and some other wealthy countries.

A recent study from the National Bureau of Economic Research confirms it: “the increase in life expectancy in the past two decades has been accompanied by an even greater increase in life years free of disability.” In other words, although longer lives mean spending more years with disease, “disability-free life expectancy” has risen faster than lifespan. Better treatments for heart disease and for vision problems—cataract surgery, that is, which has become a simple outpatient procedure—are responsible for much of the improvement, as are better diagnoses, but they don’t explain the trend. Although Parkinson’s, dementia, and diabetes remain huge concerns, even the rate of “all-cause mortality,” which lumps together chronic diseases, is falling. And every one of those diseases links to aging. Perhaps, all these degenerative diseases share something in common, something inside aging cells themselves, suggests Dr. Steven R. Cummings of the California Pacific Medical Center Research Institute. The cellular process of aging may be changing, in humans’ favor. That seems like a stretch, but more research into the biology of aging is definitely welcome and badly needed.

Why don’t more people know these things—especially the good news about dementia rates? A 2012 Marist poll found that Alzheimer’s had edged out cancer as the disease Americans fear most. Part of the reason is just human: fears loom large because danger affects survival. Part of it is because of media coverage: scary stories pull people in, and dementia is a terrifying prospect. And the alarm garners research dollars. In the words of advocate Christine Bryden, who lives with dementia, “What is the cause of the stigma and fear? It’s the stereotype of dementia: someone who cannot understand, remembers nothing, and is unaware of what is happening around them. This stereotype tugs at the heartstrings and loosens the purse strings, so is used in seeking funds for research, support, and services. It’s a Catch-22, because Alzheimer’s associations promote our image as non-persons, and make the stigma worse.” What age scholar Margaret Gullette calls “our irrational fear of forgetting” has made such deep inroads into our psyches that routine memory lapses provoke terror, and diagnoses invoke thoughts of suicide.

The odds of dementia increase with age, but the illness is not typical of aging. Our fears are way out of proportion to both the scale and the nature of the threat. Falling dementia rates ought to reduce those fears, as should the fact that the world is becoming a better place to be a person living with dementia, thanks to the work of remarkable advocates like Bryden, grassroots movements like Momentia in Seattle, and geriatrician and thought leader Bill Thomas. Thomas proposes an approach based on his Eden Alternative movement, humane communities where people with dementia thrive. Since there’s no cure for the disease, Thomas point out that, “the tool we have is culture.” Few of us are medical researchers, but each of us has the capacity to reduce the stigma and suffering associated with dementia through culture change. What can we learn from people living with dementia, how can we learn to face the disease on an emotional level, and how can we change the culture to become more inclusive?

Thomas is taking this idea on the road with his Disrupt Dementia tour, which advances the idea that a dementia-inclusive world is a human-inclusive world. That world, says tour member and psychotherapist Kyrié Carpenter, “offers a cure of sorts for what we currently call dementia.” The tour blends film, music, story-telling, and cutting-edge research into an event that turns conventional thinking on its head in a very welcome way. The tour kicked off in California this April, and it’s probably coming to a city near you. Check out the itinerary here. And be less afraid.

Related Posts

About Ashton Applewhite, ChangingAging Contributor

The author of This Chair Rocks: A Manifesto Against Ageism, Ashton Applewhite is an internationally recognized expert on ageism. She speaks widely at venues that have included the TED main stage and the United Nations and is a leading spokesperson for a movement to mobilize against discrimination on the basis of age.

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Comments

This post is like sweet water to parched lips! I come from a family with a strong family history of Alzheimers – a great grandmother, a grandmother, and a paternal uncle (my father died too young to get it). I am terrified of this disease, so for 38 years (I’m 69 now), I’ve been my own experiment. I’ve done all the research I can on the disease, and I’ve tried to incorporate everything I learn into my own life – exercising for the past 38 years, giving up gluten, eating in a Mediterranean way, taking recommended supplements, and continuing to learn always. Right now I’m learning Spanish and how to play the ukulele, along with learning how to blog. And I’m still scared . . .

So this article brings wonderful news. I’ll be back for more. Thanks so much!

I am an AGNG 320 student at the Erickson School of Aging and I find this post to be very optimistic and educational about the stigma surrounding Dementia in the United States. Dementia is a mysterious disease that is surrounded with vast fear for many but we can change that stigma through a culture shift. As we continue to improve this world for those living with dementia there must too come an improvement in the culture and continue to learn and face the disease. This post addresses many concepts we have explored in class from mental health, health education, effective care, and public health. With the falling rates of dementia, I think this is a great time to spread the word and promote the idea of an inclusive world to change the stigma around this elusive disease.

I’m an Aging 320 student at Erickson School of Aging. This is new information for me, and it is wonderful to hear something positive about a disease that we have no cure for. Even though there is no cure there are medications that there has been a tremendous surge in use, but none that have been very effective according to our textbook. So for the dementia rates to be falling even though the senior population is rising is positive. This article has put a more positive spin on the fears and stigmas that come with dementia. With the rates falling, more people may be taking better care of themselves as they are younger. That is hopefully what is happening because this will also prevent other diseases as we age if we start to take better care of ourselves as we are younger and as we age.

Boy, I find this really hard to believe, even if the stats are there. All I hear in this area is more and more people being diagnosed. Our support groups are always full. Cheers to the people who are changing the environment for people living with the disease and their care partners.

I’m an AGST320 student at the Erickson School of Aging. I was surprised to learn that dementia rates are falling so significantly, but I agree that it is a “medical mystery of the best kind.” In my AGST320 class, we discuss a lot of troubling trends in aging, so it’s good to read about a positive one. It was interesting to read about people’s fear of Alzheimer’s and to hear someone with dementia’s perspective on the source of that fear. Our textbook discusses the stigma associated with dementia as well and the irrational fear of forgetting. I had never heard of Bill Thomas’s approach, so that was very interesting to me too. We talk a lot about community-based care in not only this class, but most other HAPP classes, but we don’t often consider actually creating a community to serve populations. We look at what’s already there and how it could be improved. I think a humane community that allows people with dementia to thrive is an incredible idea that should be pursued. It is amazing that dementia rates are falling and it’s a shame that the media doesn’t typically cover those statistics. But, good news is certainly less sensational to audiences than fear and bad news. I really appreciate this blog post!